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Updated: May 11, 2026
Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
Liver surgery in the multidisciplinary management of gastrointestinal stromal tumour
Ferdinando C M Cananzi1, Ajay P Belgaumkar, Bruno Lorenzi
1Department of Surgery, The Royal Marsden, London, UK.
Introduction:
After the introduction of tyrosine kinase inhibitors (TKIs), the role of surgical resection in treating liver metastasis from gastrointestinal stromal tumour (GIST) is unclear. In this study, we evaluated the outcome of patients treated with TKIs followed by surgery for metastatic GIST.
Methods:
Eleven patients underwent liver resection after downsizing TKIs therapy for metastatic GIST from 2006 until 2010 were reviewed.
Results:
One and two-year overall survival rates were 80.8 and 70.7%. All patients with an initially resectable tumour were still alive without recurrence. Patients operated on clinical response had a better outcome (1- and 2-year overall survival (OS) rate 100%) than those operated on disease progression (1- and 2-year OS rates 60 and 40%; P = 0.043). No deaths were observed among patients who achieved an R0 resection (R0 versus R1/R2, P = 0.001).
Discussion:
R0 resection and clinical response to TKI are predictor of survival. Surgical resection should be performed as soon as feasible in responding patients. In poor responders, surgery may not add any survival benefit, except in localized progressive disease. In resectable metastatic liver disease, preoperative TKIs or upfront surgery followed by adjuvant therapy could be considered. Larger studies are needed to determine the optimum approach in patients with metastatic GIST.
Insights
Surgical resection after tyrosine kinase inhibitors (TKIs) improves survival for metastatic gastrointestinal stromal tumour (GIST) liver disease. Complete tumor removal (R0 resection) and good TKI response predict better outcomes, guiding treatment decisions.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- The role of surgical resection for liver metastasis in gastrointestinal stromal tumour (GIST) after tyrosine kinase inhibitor (TKI) introduction remains unclear.
- Evaluating outcomes for metastatic GIST patients treated with TKIs followed by surgery is crucial.
Purpose of the Study:
- To assess the survival outcomes of patients with metastatic GIST who underwent liver resection after TKI therapy.
- To identify predictors of survival in this patient cohort.
Main Methods:
- Retrospective review of eleven patients with metastatic GIST who underwent liver resection after TKI therapy between 2006 and 2010.
- Analysis of overall survival rates and recurrence based on resection status and clinical response to TKIs.
Main Results:
- One and two-year overall survival rates were 80.8% and 70.7%, respectively.
- Patients achieving R0 resection had no observed deaths (P=0.001).
- Patients operated on clinical response showed superior survival (100% 1- and 2-year OS) compared to those with disease progression (60% and 40%, P=0.043).
Conclusions:
- R0 resection and clinical response to TKIs are significant predictors of survival in metastatic GIST.
- Surgical resection should be considered early for responding patients.
- The optimal approach for metastatic GIST requires further investigation in larger studies.
